ITN 10770 Exhibit3 SampleYouthDischargeForm.pdf
PDF 80 KB Posted
- Attached to
- PRE - CINS/FINS and Respite Services
- Solicitation number
- ITN-07405
- Issued by
- Leon County, Florida
About this file
This document is an Invitation to Negotiate (ITN) issued by the Florida Department of Juvenile Justice (DJJ) to select a lead agency to provide statewide Children in Need of Services/Families in Need of Services (CINS/FINS), Statewide Detention Respite Care Services, Probation Respite Bed Services, Respite Bed Services for Civil Citation Youth, and evidence-based or promising practices delinquency prevention programming. The selected lead agency will subcontract with local service providers to deliver these services throughout Florida's 20 judicial circuits for youth between the ages of 8 and 18. The services sought include residential and non-residential care, data collection and reporting, management, and coordination of the statewide service delivery network.
The DJJ is seeking proposals from community, faith-based, not-for-profit organizations, LLCs, and/or divisions of local government to serve as the lead agency. The ITN does not provide specific pricing terms, set-asides, or funding amounts. However, it does state that the lead agency will be responsible for contracting with local service providers and overseeing all components of training, service delivery, contract management, and operations.
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Other files
| File | Type | Posted |
|---|---|---|
| ITN 10770 Attachment T.docx | DOCX document | |
| ITN_10770_FinalAgencyDecision.pdf | ||
| ITN 10770 Ex4 StartUpImplementationPlan.docx | DOCX document | |
| ITN 10770 Informational Notice 1.pdf | ||
| ITN 10770 solicitation document.pdf | ||
| ITN 10770 Ex7 ServiceUtilizationReport.xlsx | XLSX spreadsheet | |
| ITN_10770_Attachment_N.docx | DOCX document | |
| ITN 10770 Attachment J.xlsx | XLSX spreadsheet | |
| ITN 10770 Attachment Q.pdf | ||
| ITN 10770 Attachment R.docx | DOCX document | |
| ITN 10770 Exhibit1 Invoice.pdf |
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Text version
ITN #10770
EXHIBIT 3
SAMPLE YOUTH DISCHARGE FORM
Youth’s Name (First initial, Last name) _____________________________________________
JJIS Number ___________________________________________________________________
Admission Date_________________________________________________________________
Discharge Date_________________________________________________________________
Program Instructor’s Signature____________________________________________________
*If services are not rendered within a 30-day period, the youth will be released/discharged from the program.
A Youth Discharge form with a properly prepared invoice shall be submitted directly to the Department’s
Contract Manager within 15 business days following the end of the month for which services were rendered.
File details come from the government source that posted it. Updated .